Active NPI
Lawrence Pei-Wen Wang
- Optometrist
- Covington, WA
National Provider Identifier
1003950494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3495
- Practice address
- 16735 SE 272ND St
Suite C
Covington, WA 98042-4942 - Phone
- (253) 639-4077
- NPI assigned
- Feb 18, 2007
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3495 | WA | Primary |
Addresses
Primary practice location
16735 SE 272ND St
Suite C
Covington, WA 98042-4942
Mailing address
PO Box 1834
Issaquah, WA 98027-0075
Phone (425) 687-7981
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WA1418 | Other | WA | REGENCE BLUE SHIELD |
| 2030690 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3495 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| See Jane Inc | Optometrist | Current | Accepting new patients |
| NW Eye Docs, Inc. | Optometrist | Past | Accepting new patients |
Locations
5335 NE 4th St
Ste 4
Renton, WA 98059
Phone (425) 282-5475
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Covington, WA
- NPI 1073655668
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1003950494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1834",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980270075",
"telephone_number": "425-687-7981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16735 SE 272ND ST",
"address_2": "SUITE C",
"city": "COVINGTON",
"state": "WA",
"postal_code": "980424942",
"telephone_number": "253-639-4077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANG",
"first_name": "LAWRENCE",
"middle_name": "PEI-WEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-18",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "3495",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "WA1418",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2030690",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.